Rising prescription drug costs pricing pharmacies out of business

PHILADELPHIA (WPVI) -- Filling a prescription is becoming harder and harder for some consumers as pharmacies are in the midst of what the industry is calling "a crisis."

Eighty pharmacies have closed in Pennsylvania since January 1st and many more closures could be coming. Legislation has been introduced designed to alleviate the problem.

"A pharmacy is the most accessible health care provider. Patients can walk in on a daily basis with no notice and it's our job to help them," said Dennis Czerw, owner of Parkway Pharmacy in Center City Philadelphia.

But we are seeing more and more empty storefronts where pharmacies used to be, creating what is called a "pharmacy desert" in one in four neighborhoods nationwide most of them Black, Latino, and low-income.

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"This is happening it's happening in the inner cities it's happening to the people that need the most help," said Czerw.

A big reason for the closures is many pharmacies are losing money filling prescriptions.

"You can lose 80-percent of the cost of a medication," said Czerw.

For Barry Thaler that's his diabetes medicine.

"On his one medication we can lose $70 filling a hard to find medication," said Czerw. "It makes me feel terrible that we can't do it for him."

Pharmacies put much of the blame on Pharmacy Benefit Managers. PBMs decide how much a pharmacy gets reimbursed for dispensing a prescription. They also create pharmacy networks for insurers, which steer patients to specific big pharmacy chains with which it has deals.

"I speak on behalf of my colleagues when I tell you we're fed up, we're done," said Chris Antypas, President, Perigon Pharmacy 360 during a Pennsylvania Senate Hearing.

Senate Bill 1000 was introduced as a way to help fix the problem by giving the state more oversight of PBMs. It creates a process for hearing and resolving complaints against PBMs, requires PBMs to report to the state the amount of rebates and payments it gets from drug manufacturers and limits or bans practices like patient steering.

"It's going to provide some much needed transparency in the industry," said Czerw.

But the organization that represents PBMs says the passage of Senate Bill 1000 would "significantly restrict the tools that PBMs use to lower drug costs" and could push drug prices higher.

Full Statement from the Pharmaceutical Care Management Association

"The legislation represents a serious risk to Pennsylvania health care costs. By significantly restricting the tools PBMs use to lower drug costs and mandating disclosure of information that could give drug companies more power to increase prices, the result of the legislation would be soaring drug costs for Pennsylvania health plans and patients. According to our estimate, if implemented, just in its first year the bill could increase drug costs in Pennsylvania by as much as $1.5 billion.

Pharmacy benefit companies recognize the vital role pharmacies play in Pennsylvania creating access to prescription drugs for patients. In support of that critical role, PBMs support rural pharmacies in Pennsylvania, and nationwide, through innovative programs that increase on prescription drugs."

- Greg Lopes, PCMA spokesperson